Tag: miss jaime ot

“How am I supposed to teach him to tie his shoes?”
The Occupational Therapy student’s cheeks were pink. A concerned look creased her face.

Self-doubt was creeping in. I understood.

Sometimes you get a child on your caseload that seems to have a lot of obstacles to face, just to live a normal independent life.

This little boy was no exception. Charlie was born with amniotic banding, a rare condition caused by fibrous strands of the amniotic sac entangling the limbs or other parts of the body, which can cause deformities in utero. In Charlie’s case, he was born without his left hand.

How do you teach bilateral skills like cutting, buttoning, and tying to a child with only one hand?

You adapt. And you teach them to adapt. There’s always a way.

Every child deserves to live a full and happy life.

They deserve to be independent.

And they deserve to accomplish typical milestones, such as tying their shoes for the first time.

I love to use adaptive tools to make these mountainous challenges just a bit easier for my little guys. So I was super excited to tell my OT student about Zubits.

An exciting guest post from 4th-grade teacher, Jennifer O’Brien about the Hidden Benefits of Flexible Seating!

*This post contains affilaite links

Prior to implementing flexible seating in my classroom, I did A LOT of research. A flexible seating transformation is so much more than just buying new furniture. There are rules and expectations that must be clearly communicated to the students to ensure an easy transition. While I prepared myself for this change, I learned about some of the benefits of flexible seating:

Comfort: Students are more comfortable, allowing them to focus for longer periods of time. This leads to higher academic achievement.

Differentiated Seating: Flexible seating is essentially “differentiated” seating. There are many different choices, some options giving children the sensory input that they need.

Improved Behavior: Students are less disruptive and are able to burn off energy throughout the day.

The “hidden benefits”

When I made this commitment, I never would’ve thought that I’d see such positive changes (so quickly, too!) within my classroom.

New Friendships

With flexible seating, students aren’t tied down to one desk or seating arrangement. Throughout the day, they are sitting with different children. I have seen new friendships grow from this and I feel like it has only brought my students, and my class as a whole, closer.

Collaboration

Tables replaced the desks that were removed from my classroom during this transformation. I’ll admit- I was nervous that this would lead to a much noisier room, but that did not happen. Instead, I found that there was more productive chatter around the classroom. Tables foster a much more collaborative learning environment. I feel that this has also led to the development of stronger social skills in many of my students.

FREEBIE: Choosing the Right Alternative Seating Option

Improved Self-Monitoring Skills

The purpose of flexible seating is to give students the power of choice. They should be comfortable and ready to learn. This has been one of the more challenging skills to master but it has helped my students develop a necessary awareness throughout the school day. When I ask students to choose a “smart spot”, they know what is expected of them. It has been amazing to see them mature with this concept, understanding what both concentration and productivity should look like. When students feel like they cannot focus or that need to move, they may do so.

Stronger Classroom Management

Since I was rolling outthis transformation mid-year, I knew that my classroom management had to be strong. Clear rules and expectations arecritical and must remain consistent. Seeing my students understand the daily routine and take responsibility for their learninghas been incredible.I’ve learned so much through this experience, and I believe it has made me a stronger, more effective teacher. Stronger classroom management is definitely a hidden benefit of flexible seating!

Interested in learning more about Alternative Seating? Check out:

It’s almost Back to School time! Get 50% off the Guide to Alternative Seating for the Classroom until the end of August. Use Promo Code: BTS50

Jennifer O’Brien has a Master’s degree in Literacy from St. Joseph’s College in Patchogue, N.Y.. She is General Education and Special Education certified birth-6th grade. Jennifer has been a public school teacher on Long Island for 3 years. In her spare time, she enjoys creating supplemental resources for her students to use as well as reading and going to the beach! Check out Jennifer’s Teachers Pay Teachers Store.

Potty-training can be a challenge for parents, but it’s also an important part childhood development. The normal struggle can be even more difficult when there are sensory processing issues. Recognizing that they need to go, wearing big girl or big boy underwear, and being able to use different toilets can all be impacted by sensory processing.

Why does Sensory processing matter?

Toileting requires a significant amount of body awareness. Children have to understand how their body is feeling, learn how to release their bowel and bladder muscles in order to go, and feel that they have “finished” and their bowel or bladder is now empty.

Sensory processing is a natural part of the toileting process.

A bathroom environment can be overstimulating to start with. We receive sensory information from our eyes, ears, skin, muscles, and joints and our brain’s job is to organize the information, select the important parts, and disregard the rest. When a child’s sensory systems are functioning appropriately, they are able to participate in activities of daily living such as potty-training. However, if the sensory systems are not integrated properly, toileting can become problematic.

what is Sensory Processing?

Sensory Processing refers to how the nervous system detects, regulates, interprets and responds to sensory information. Sensory Processing is an important factor in considering a child’s attention, memory, behavior, and function (Ahn, Miller, Milberger, & McIntosh, 2004; Gardner &Johnson, 2013). A child’s brain needs to be able to register sensory information from the environment and react appropriately to it. If a child has difficulty regulating and processing sensory information, they may have Sensory Processing Disorder.

Sensory Processing Disorder is a neurological disorder in which the sensory information that a child perceives results in abnormal responses. Children who have difficulty processing sensory information often have inconsistent responses because they have a hard time discriminating between which sensory information is important and which can be ignored.

It is important to note that many children (and adults for that matter) have difficulty with processing certain types of sensory input. Typical things such as disliking certain smells or textures, feeling seasick on rides, or preferring certain foods do not necessarily mean that a child has sensory processing disorder. They may simply still be learning to process certain sensory stimuli.

There are eight sensory systems in our bodies:

Tactile System (touch)

Vestibular System (balance)

Proprioceptive System (position in space)

Olfactory System (smell)

Visual System (sight)

Auditory System (hearing)

Gustatory System (taste)

Interoceptive System (internal body awareness)

Interoception is our ability to sense what is going on inside our bodies internally. It includes sensations such as thirst, hunger, fatigue, pain, breath, itchiness, nausea, temperature, etc. It also includes our sense of if we have a full bladder or bowel, and if we have “released” it. (Garland, 2014).

An Explanation of the Sensory Systems related to Toileting

The proprioceptive, vestibular, and touch senses are primary influences on the integration of our senses. The interoceptive sense also plays a crucial role in developing the foundational body awareness needed to function as a child.

When a child is unable to integrate and react to sensory information appropriately, the child will not interact with his environment in a functional manner. He may have exaggerated responses to typical noises or sensations or withdraw from certain stimuli. The child cannot consistently process sensory information, so their responses will be inconsistent, too.

If the child has decreased body awareness, they may demonstrate an inefficient grading of force or movement. For a boy, this may mean they have difficulty using the right amount of force when holding or aiming the penis. This might result in a child pressing so hard that it’s difficult to pee, holding too tightly, or having difficulty holding steady.

Our vestibular system helps us to maintain our balance. The fluid in our inner ear moves as our head moves, sending messages to our brain about where our body is in space (Abraham, 2002). Some children with vestibular dysfunction present with “gravitational insecurity“, which makes them seek a secure position during activities. They may dislike swings, being picked up, or participating in activities in which they are not in control of their body in space. These children might be fearful when attempting to sit on a “grown-up” toilet where their bottom is unsupported because they feel like they may fall.

Children with vestibular, tactile, and proprioception difficulties may have difficulty with eye-hand coordination and depth perception. It may be difficult for them to aim appropriately or estimate where to stand.

Many children with sensory processing difficulties have auditory sensitivities that interfere with toilet training. Think of the loud echoes, flushing toilet, the hand dryers, etc. Noises that are simply loud to an adult can be piercing to a child with auditory sensitivities.

Tactile sensitivities can interfere with toileting, too! Children may dislike the sensation of pooping, wiping, or even sitting on a hard seat. If they are under-responsive to touch, they may not realize that they aren’t covering their hand properly with the toilet paper, they aren’t wiping well enough to clean themselves, or that they’ve soiled their clothing.

Sensory Processing and Body Awareness needed for Toilet Training

When our body is able to receive and interpret the signals from our skin, muscles, and joints, we are able to feel and know what our body is doing without looking at it. When a child has poor body awareness, it can lead to difficulty coordinating their body to do all of the components that are involved in toileting. It is not automatic to feel the urge to go and just go to the bathroom. Each step of the task must be thought out and carefully performed, so it is important to be patient. It’s hard to know what to do if you can’t feel what you are supposed to feel!

Typically, toddlers and preschoolers spend a lot of time learning the “ins and outs” of toileting. Children are expected to be toileting independently before entering Kindergarten. Children with difficulties modulating sensory input find potty training to be a much bigger challenge than a typical child. The bathroom can be an overstimulating environment, so asking a child with sensory integration difficulties to focus on the task at hand (ie; peeing or pooping) is a challenge if they are overwhelmed with fear or anxiety about other sensory signals they are receiving. Problems with toileting and sensory processing might include (but not be limited to) the following:

Toileting and Sensory Processing Problems

1. Toileting and Sensory Processing Related to Poor Interoception

May be unaware that his bowel or bladder is full.

Feels that they need to go, but not be able to discriminate whether they need to urinate OR have a bowel movement.

Unable to “push” in order to go; don’t understand how to make those muscles work

Cannot feel that they have had an accident or that their clothes are soiled.

Unable to bend and reach behind them to properly wipe

2. Toileting and Sensory Processing Related to Sensory Defensiveness

Dislikes the feeling of “peeing” or “pooping” and withholds.

Fearful of falling into a regular sized toilet

Dislikes the feeling of wiping or being wiped.

Prefers the parent to wipe them

Does not like to wash their hands

Takes off all their clothes to use a toilet

Avoids flushing the toilet

3. Toileting and Sensory Processing Issues Related to Poor Registration of Sensory Input with a Hyperactive or Over-reactive Response

The child is fearful of the sensations involved when they pee or poop.

Reports that the act of “peeing” or “pooing” hurts terribly, crying, etc.

Extreme reaction to the sound of the flush or the air dryer

Gags, or chokes at the smell of the poop

Visually distracted by details in the bathroom, including lines in the tile, dust on the floor, etc.

Will tell you when the diaper needs to be changed, doesn’t want a wet diaper

Difficulty tolerating new bathrooms, public bathrooms, etc.

Covers ears when flushing, air hand dryer goes on, etc.

Holds nose for bowel movements

Avoids using certain toilets with “hard” seats

Avoids going into the bathroom, “sneaks off” to poop in diaper behind a couch, etc.

How to Help: 15 Amazing Strategies for Toileting

1. Try a 4 in 1 Stages Potty Seat which is closer to the ground and fits a smaller bottom. It also helps transition to use a grown-up toilet

2. Try fun potty seats like this Race Car Potty and Character Underwear that are motivating!

3. Try using flushable wipes and a Wipes Warmer to make the experience of wiping more enjoyable

* one consideration for this is that your child may begin to rely on it…. if you are out in public and don’t have warm wipes, will it be a problem? Take that into consideration before making it part of your routine. But if you are desperate, it’s worth a shot!

4. Sing Songs to make toilet training more fun:

“Let it go! Let it go!”

“Push it out, Push it out, WAY OUT!”

“Pee Pee in the Potty, Pee Pee in the Potty!”

“I just want to Potty all the time, Potty all the time, Potty all the time!”

5. Use painter’s tape to make a line for boys to know where to stand

6. Offer Toilet Targets or use goldfish crackers or fruit loops (get the pee in the hole!)

7. For children who aren’t sure if they have to pee OR poop, let them sit. It’s hard to tell which muscles are which.

13. Try a toileting schedule. Have your child sit on the toilet every 15 minutes for a few minutes. If they go, Wahoo! big Praise. If not, that’s ok, we’ll try again in 15 minutes.

14. Provide a Kitchen Timer for set “potty” sitting times. Let your child set the timer so they are a part of the process.

15. If your child is fearful of the sensation of pooping in the toilet, have them help you dump the poop from the diaper into the toilet and then flush it.

Toileting and Sensory Processing in Children with Special Needs

Very often problems with potty-training, such as accidents, difficulty recognizing if they have to go, struggles with hygiene, fear of flushing, and refusal to use the toilet are the result of an inefficient sensory processing system. It is important to note that children with developmental delays and other diagnoses may need more time to be trained. As parents and educators, it is essential to treat the process with patience. Your child has a lot of information and sensory signals to make sense of and every child has to go at their own pace. Do not feel the “peer pressure” from other parents that your child “should be” ready.

Functional Skills for Kids

This post is part of the Functional Skills for Kids series. See all of the bloggers who are participating and more about the series here. For more information on the components and considerations related to Toileting, stop by and see what the other Occupational Therapists and Physical Therapists on the Functional Skills for Kids team have to say:

As a pediatric Occupational Therapist, I hear this from a lot of moms and teachers. Pencil and crayon grip is important, and it can be difficult to change when a child gets older.

But there’s hope! I promise!

CASE STUDY: HARRY

This is Harry, a 4-year-old with no interest in crayons. In the first picture, he’s using a palmar supinate grasp, which is typically seen in 1 to 1 ½ year olds. His mom, a teacher that I work, with approached me looking for help. Her question:

How can I change my child’s grasp?

Harry’s preferred grasp was a palmar supinate, using the pinky side of his hand to control the movement of the crayon. This grasp was inefficient and immature for his age. It also didn’t allow the small isolated movements of his fingers during writing and drawing activities. Coloring and drawing are a significant source of the fine motor exercise a 4-year-old child should be getting. So if the child isn’t using the right muscles for the activity, they are missing out on valuable strengthening time.

As you can see by the 2nd image above, Harry’s mom took my recommendations – and it WORKED!

I’m so excited to share my favorite trick to stop kids from using too many fingers AND 2 magical crayons to use. But here’s why these tricks are important for parents and teachers to know.